Analysis of the lungs to breathe into the tube. Examination of the function of external respiration (RF): what is it. How is the study going

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Examination of the function of external respiration

Prices for the study of the function of external respiration

The study of external respiration is carried out by three methods: Spirography, Body plethysmography, Diffusion ability of the lungs.

Spirography- basic study of the function of external respiration. As a result of the study, they get an idea of the presence or absence of violations of bronchial patency. The latter arise as a result of inflammatory processes, bronchospasm, and other causes. Spirography allows you to determine how pronounced the changes in bronchial patency are, at what level the bronchial tree is affected, how pronounced the pathological process is. Such data are necessary for the diagnosis of bronchial asthma, chronic obstructive pulmonary disease and some other pathological processes. Spirography is performed for the selection of therapy, control over treatment, selection for sanatorium treatment, determination of temporary and permanent disability.

In order to determine how reversible the pathological process is, functional tests are used to select treatment. At the same time, a spirogram is recorded, then the patient inhales (inhales) a medicine that expands the bronchi. After that, the spirogram is recorded again. Comparison of data before the use of the drug and obtained after its use, allows us to conclude that the pathological process is reversible.

Often, spirography is performed on healthy people. This is necessary for the implementation of professional selection, for planning and performing training sessions that require tension in the respiratory system, confirmation of the fact of health, etc.

Spirography provides valuable information about the state of the respiratory system. Often, spirography data must be confirmed by other methods, or to clarify the nature of the changes, to identify or refute the assumption of lung tissue involvement in the pathological process, to detail the idea of the state of metabolism in the lungs, etc. In all these and other cases, body plethysmography is used and carried out study of the diffusion capacity of the lungs.

Body plethysmography - if necessary, performed after a basic study - spirography. The method with high accuracy determines the parameters of external respiration, which cannot be obtained by conducting only one spirography. These parameters include determination of all lung volumes, capacities, including total lung capacity.

The study of the diffusion capacity of the lungs is performed after spirography and body plethysmography to diagnose emphysema (increased airiness of the lung tissue) or fibrosis (compaction of the lung tissue due to various diseases - broncho-pulmonary, rheumatic, etc.). In the lungs, gases are exchanged between the internal and external environment of the body. The entry of oxygen into the blood and the removal of carbon dioxide is carried out by diffusion - the penetration of gases through the walls of the capillaries and alveoli. The conclusion about how efficiently gas exchange proceeds can be drawn from the results of a study of the diffusion capacity of the lungs.

Why it is worth doing in our clinic

Often, the results of spirography require clarification or detail. FSCC FMBA of Russia has special devices. These devices allow, if necessary, to carry out additional studies and clarify the results of spirography.

Spirographs, which our clinic has, are modern, allow in a short time to obtain many parameters for assessing the state of the external respiration system.

All studies of the function of external respiration are performed on a multifunctional installation of the expert class Master Screen Body Erich-Jäger (Germany).

Indications

Spirography is performed to establish the fact of health; establishing and clarifying the diagnosis (bronchitis, pneumonia, bronchial asthma, chronic obstructive pulmonary disease); preparation for surgery; selection of treatment and control of ongoing treatment; assessment of the patient's condition; clarifying the causes and forecasting the timing of temporary disability and in many other cases.

Contraindications

Early (up to 24 hours) postoperative period. Contraindications are determined by the attending physician.

Methodology

The subject performs various breathing maneuvers (calm breathing, deep inhalation and exhalation), following the instructions of the nurse. All maneuvers must be performed carefully, with the right degree of inhalation and exhalation.

Training

The attending physician may cancel or limit the intake of certain medications (inhalation, tablets, injections). Before the study (at least 2 hours) smoking stops. Spirography is best done before breakfast, or 2 to 3 hours after a light breakfast. It is advisable to be at rest before the study.

- a method for determining lung volumes and capacities when performing various respiratory maneuvers (measuring VC and its components, as well as FVC and FEV

Spirography- a method of graphic registration of changes in lung volumes and capacities during quiet breathing and performing various respiratory maneuvers. Spirography allows you to evaluate lung volumes and capacities, indicators of bronchial patency, some indicators of pulmonary ventilation (MOD, MVL), oxygen consumption by the body - P0 2.

In our clinic, the diagnosis of the function of external respiration (spirometry) is performed on a modern software and hardware complex. The diagnostic device, the sensor of which is equipped with a disposable interchangeable mouthpiece, measures the speed and volume of air you exhale in real time. Data from the sensor enters the computer and is processed by a program that captures the slightest deviations from the norm. Then the doctor of functional diagnostics evaluates the initial data and the product of the computer analysis of the spirogram, correlates them with the data of previously performed studies and the individual characteristics of the patient. The results of the study are reflected in a detailed written conclusion.

For a more accurate diagnosis, usebronchodilator test. Breathing parameters are measured before and after inhalation of a bronchodilator drug. If initially the bronchi were narrowed (spasmodic), then during the second measurement, against the background of the action of inhalation, the volume and speed of exhaled air will increase significantly. The difference between the first and second study is calculated by the program, interpreted by the doctor and described in the conclusion.

Study preparation functions of external respiration (spirometry)

Do not smoke or drink coffee 1 hour before the examination.
Light food intake 2-3 hours before the study.
Cancellation of drugs (on the recommendation of a doctor): short-acting b2-agonists (salbutomol, ventolin, berodual, berotek, atrovent) - 4-6 hours before the study; b2-agonists of prolonged action (salmeterol, formoterol) - for 12 hours; prolonged theophyllines - for 23 hours; inhaled corticosteroids (seretide, symbicort, beclazone) - for 24 hours.
Bring your medical card with you.

Indications for the study of the function of external respiration (spirometry):

1. Diagnosis of bronchial asthma and chronic obstructive pulmonary disease (COPD). Based on the data of respiratory function and laboratory tests, it is possible to confirm or reject the diagnosis with certainty.

2. Evaluation of the effectiveness of treatment by changes in the spirogram helps us choose exactly the treatment that will have the best effect.

FVD determines how much air enters and exits your lungs and how well it moves. The test checks how well your lungs are working. It may be done to check for lung disease, response to treatment, or to determine how well the lungs are working before surgery.

Terms and conditions for spirometry

It is advisable to conduct the study in the morning (this is the best option), on an empty stomach or 1-1.5 hours after a light breakfast.
Before the test, the patient should be at rest for 15-20 minutes. All factors that cause emotional arousal should be excluded.
The time of day and year should be taken into account, since persons suffering from pulmonary diseases are more susceptible to daily fluctuations in indicators than healthy people. In this regard, repeated studies should be carried out at the same time of day.
The patient should not smoke for at least 1 hour before the examination. It is useful to record the exact timing of the last cigarette and drug intake, the degree of patient-operator cooperation, and some adverse reactions such as coughing.
Measure the subject's weight and height without shoes.
The patient should be thoroughly explained the procedure for the study. At the same time, it is necessary to focus on preventing air from leaking into the environment past the mouthpiece and applying maximum inspiratory and expiratory efforts during the corresponding maneuvers.
The study should be performed on the patient in an upright sitting position with a slightly raised head. This is due to the fact that lung volumes are highly dependent on body position and are significantly reduced in a horizontal position compared to a sitting or standing position. The chair for the subject should be comfortable, without wheels.
As the exhalation maneuver is performed until the OOL is reached, forward tilts of the body are undesirable, since this causes compression of the trachea and contributes to saliva entering the mouthpiece, head tilts and neck flexion are also undesirable, as this changes the viscous-elastic properties of the trachea.
Since the chest must be free to move during respiratory maneuvers, tight clothing must be loosened.
Dental prostheses, except for very loose ones, should not be removed prior to examination, as the lips and cheeks lose their support, allowing air to escape past the mouthpiece. The latter should be captured by teeth and lips. It is necessary to ensure that there are no cracks in the corners of the mouth.
A clamp is put on the patient's nose, which is necessary for measurements performed with quiet breathing and maximum ventilation of the lungs in order to avoid air leakage through the nose. It is difficult to exhale (partially) through the nose during the FVC maneuver, but it is recommended to use a nose clip during such maneuvers, especially if the forced expiratory time is significantly prolonged.

Close interaction and mutual understanding between the nurse conducting the study and the patient is very important. poor or incorrect execution of maneuvers will lead to erroneous results and an incorrect conclusion.

FVD is a function of external respiration. Thanks to the examination of the respiratory function, the doctor can find out if the patient's lungs are healthy.

FVD with salbutamol: examination features, preparation, technique.

To understand whether there are any deviations in the work of the respiratory system or not, a test with Salbutamol is used. Salbutamol is a drug that dilates the bronchi.

Training

The doctor himself tells the details of the preparation, based on the patient's case. But, despite this, there are main aspects of preparation:

The FVD session can begin only after the patient sits in a free relaxed position, in a well-ventilated room with a normal temperature (not exceeding +20 degrees Celsius).
The rest of the patient before the examination should be about thirty minutes.
Do not smoke or drink alcohol the day before the examination. Also, you can not wear clothes that squeeze the chest and prevent normal breathing.

If you follow all the rules in preparing for the FVD examination, the results of the examination are guaranteed to be reliable.

Technique

In order to conduct a study of the respiratory function, you need a device called a spirometer. The doctor who prepared the spirometer puts a mouthpiece on it and measures the indicators. In addition, the FVD examination includes putting a clamp on the patient's nose and inserting a tube into the patient's mouth.

The sequence of the survey

The patient needs to stand or sit.
In order to prevent air from entering the patient's nose, a clip is installed.
A special tube is inserted into the patient's mouth.

After the patient is ready for the examination, the doctor must give the patient instructions to follow. The patient is advised to take a strong breath, and then a long and no less strong exhalation.

You can watch how the spirometer works in the video at the link

FVD: research methods

The study of the functions of external respiration (RF) contains such techniques as:

spirography- determines changes in indicators in air volumes;
peak flowmetry- determines the speed with which a person exhales.

A little about our breath

Respiration is a physiological process that provides a normal metabolism, receiving oxygen from the environment and removing carbon dioxide into the environment.

In case of violations in the work of the respiratory organs, studies of the ventilation function of the lungs are carried out.

FVC (forced vital capacity)- this is the amount of air exhaled with intensification after a strong inspiration.
VC (vital capacity) is the largest volume of air exhaled after a forced inhalation.

Study of the functions of external respiration

Since in recent days there has been an increase in bronchological diseases, the study of respiratory function becomes necessary. To identify any pulmonary diseases or disorders in the functioning of the pulmonary system, a fvd study is used.

Indications and contraindications

An examination cannot be carried out in the following cases:

heart failure;
acute infectious diseases;
high blood pressure;
severe angina.

Also, the study is contraindicated in children and people with mental disabilities who will not be able to follow the doctor's instructions.

Indications for research:

asthma;
bronchitis;
silicosis;
pneumonia and others.

Blood gas studies

Blood is a mobile connective tissue.

A blood gas study examines a patient's arterial blood.

Blood for research is taken from the brachial, radial or femoral artery.

The components of the blood that keep the body's hydrogen level in a normal state are called pH. Norm: 7, 30 - 7, 49.

Exceeding the normal threshold can result in serious illness or even death. A decrease indicates that the patient has pathological processes.

Many important processes such as biosynthesis, stimulation of cell fermentation, muscle and nerve transmission depend on the condition of the human blood.

Blood gas changes can be metabolic or respiratory. The respiratory one depends on the normal level of carbon dioxide, and the metabolic one depends on the reaction of the change in the content of sodium bicarbonate in the blood fluid.

Examination of respiratory function: spirography, provacation test with methancholine, body plethysmography

Spirography- this is a procedure that helps to identify any diseases of the respiratory system in the early stages

With the help of spirography, you can find out if there are any disorders in the functioning of the respiratory system.

Based on the indicators of air volumes, the respiratory function is determined.

The examination is carried out using a spirometer. To study the respiratory function using spirography, a clamp is applied to the patient's nose, which is used to prevent air from entering the nose, and a special tube is placed in the mouth.

The patient needs to exhale into the tube of the device.

The spirometer contains electronic sensors that record how much air is exhaled and at what speed.

Conducting a study of the function of the respiratory system using spirography can be seen below:

Provocative test with methancholine

It often happens that the doctor cannot say for sure whether the patient has asthma or not. In order to accurately determine the presence or absence of asthma, you need to use a provocative test with methancholine.

This type of spirometry reveals readiness for bronchospasm, hyperactivity and asthma. Only due to this type of spirometry it is possible to say for sure whether a person has asthma or not.

Due to this test, you can find out the presence of any bronchial asthma.

Bodyplethysmography

Body plethysmography is similar in many ways to conventional spirometry, but body plethysmography can provide more information. It determines all the volumes of the lungs.

The main aspects of undergoing body plethysmography:

The patient needs to sit in a special booth, which is equipped with a pneumotograph.
During body plethysmography, the patient needs to breathe through a tube and follow all the instructions of the doctor.
Any fluctuations of the chest during body plethysmography are recorded.
After that, you can immediately get the results of the survey.

You can learn more about body plethysmography from the informative video

Study of the diffusion features of the lungs

The diffusion test evaluates the ability of the lungs to deliver gas to red blood cells. This test requires expensive equipment and highly qualified doctors.

Aspects of preparation for the study of respiratory function: spirometry and body plethysmography

The day before the FVD, you can not smoke, eat tightly and take bronchodilator drugs.

What is spirometry and how is it performed?

Spirometry is used to measure lung parameters. A spirometric study reveals respiratory diseases, determines the severity of the pathology.

Preparation for spirometry

For the accuracy of spirometry results, you must:

On the day before the study, do not take drugs that have an effect on the respiratory processes.
Before the start of the session, do not drink strong tea or coffee. Do not use tobacco.
Do not wear tight clothing the day before the procedure.
Before starting the session, you need to rest for about thirty minutes.

The sequence of spirometry

The patient needs to sit or lie down.
The doctor needs to put a clamp on the patient's nose.
And then insert the tube into your mouth.
After the doctor's command, the patient needs to take a strong breath, and then a strong and long exhalation.

Indications for spirometry

When the respiratory system fails, lung function decreases. Spirometry helps to identify diseases.

Indications for carrying out:

allergy;
poor gas exchange;
respiratory diseases;
physical condition assessment;
readiness for intervention of the surgeon;
detection of chronic obstructive pulmonary disease (COPD).

Indicators of the norm of spirometry. Table.

What is FVD - research? Does it hurt?

The study of respiratory function is a check of the condition of the lungs, the identification of diseases of the respiratory system. The study of respiratory function contributes to the identification of diseases in the initial stages and the diagnosis of their treatment.

FVD examination can be carried out in three ways:

spirography;
peak flowmetry;
pneumotachometry.

Is it painful to get tested?

Examination of the FVD does not hurt at all. All the patient needs to do is inhale and exhale into the tube at the doctor's command.

FVD study in Moscow

The study of respiratory function allows you to identify diseases of the lung disease in the initial stages and diagnose their treatment. Since the FVD study contains many different methods, the prices will be different depending on the method, the equipment used, and the medicines used.

The most budgetary type of diagnostics is pneumotachography. On average, the procedure can cost about 500 rubles.

The study of respiratory function using spirography costs an average of 800 rubles. Below is a list of clinics in Moscow where you can undergo spirography:

Spirometry - a study of respiratory function

Spirometry is a procedure that detects various diseases of the respiratory system at an early stage. In some cases, spirometry may be prescribed to teach proper breathing.

Indications for spirometry

chronic cough or shortness of breath;
allergy;
violation of gas exchange;
respiratory diseases;
physical condition assessment;
preparation for the intervention of the surgeon;
detection of chronic obstructive pulmonary disease.

Aspects of preparation for spirometry.

In order to get accurate spirometry results, you must:

the day before the examination, do not take drugs that have any effect on the respiratory processes and respiratory organs;
three to five hours before the examination, do not drink strong tea and coffee;
do not smoke three to five hours before the study;
the day before the examination, do not wear clothing that interferes with breathing and compresses the chest.

Algorithm for spirometry

the patient should stand or take a sitting position;
a clip is put on the patient's nose;
a special tube is inserted into the patient's mouth;
at the direction of the doctor, the patient should take a deep breath, and then a strong and prolonged exhalation.

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“External respiration” is a general term that describes the process of moving air in the respiratory system, its distribution in the lungs and the transport of gases from the air to the blood and back.

Diagnosis of the function of external respiration (RF) is a method for studying the functions of lung ventilation by means of graphic fixation during various respiratory actions. Readings help to understand some aspects of lung function.

Why is it necessary to study the functions of external respiration

Any deviation in the tissues and respiratory organs provokes a violation of the respiratory process, and any changes in the functions of the bronchi and lungs can be detected on the spirogram. If pathology is not detected in time, then the disease can affect the chest (pump), lung tissue (gas exchange and oxygenation) or the respiratory tract (free movement of air).

During the study of the respiratory organs, not only the presence of respiratory dysfunction is revealed, but also a clear understanding appears which area of the lungs has been damaged, how quickly the disease passes, what treatment methods are suitable in a particular case.

When examining the respiratory function, several indications are simultaneously recorded, which are based on gender, age, height, weight, genetics, lifestyle and existing chronic diseases. That is why the interpretation of these indicators should be carried out by the attending doctor.

Moreover, the results of the study of respiratory function help to determine the source of dyspnea and the extent of respiratory system disorders, select the correct treatment and determine the level of its effectiveness, detect reduced lung ventilation and establish the nature of its severity, calculate the reversibility of disorders when using bronchodilators, and also track the frequency of bronchopulmonary modifications. tree during the course of the disease.

Research types

Spirometry (spirometry) is based on the identification of the working state of the respiratory organs. Completely painless and fast process, therefore it is not contraindicated for children. It helps to make a conclusion about which area is affected, how much the functional indicators have decreased, and to what extent these deviations are dangerous.

Pneumotachometry - measurement of the patency of the respiratory tract. It is carried out using a special device that sets the speed of the air flow during inhalation and exhalation. It is mainly used to study diseases in a chronic form.

The study of respiratory effort - describes the deviation of the maximum speed of air entering the lungs with increased inhalation and exhalation, thereby helping to assess the position of bronchial patency.

Body plethysmography - studies of respiratory function by comparing the results of spirography and indicators of mechanical variations of the chest during the entire breathing cycle. Allows you to detect the real volume of the lungs, which is not displayed during spirometry.

The study of the diffusion capacity of the lungs - reveals an indicator of the ability of the lungs to transport oxygen into human blood. It is considered a significant diagnostic method, therefore it is included in the list of mandatory respiratory function studies for interstitial and disseminated lung ailments.

Spirometry test with bronchodilators - performed to assess the reversibility of the obstruction. Helps to distinguish between COPD and asthma and indicate the stage of development of the disease.

Indications and contraindications for the procedure

The study of the function of external respiration has the following indications:

complaints of changes in breathing, coughing and shortness of breath;
asthma, COPD;
pathology of the lungs, which was discovered during another diagnosis;
a large amount of carbon dioxide and a small amount of oxygen in the blood;
preoperative or invasive examination of the respiratory system;
screening study of people who smoke, employees of hazardous factories and people who have respiratory allergies.

Like any form of research, FVD also has a number of contraindications, including bleeding in the bronchi or lungs, aortic aneurysm, tuberculosis, stroke or heart attack, pneumothorax, mental or mental disorders.

The process of studying the function of external respiration

First, the patient is explained the research method and the rules of the patient's behavior during the examination: how to breathe correctly, when to breathe with effort, when to hold your breath, and so on. If necessary, the patient is offered additional diagnostics that will help establish a more accurate diagnosis.

The study of FVD takes place in a sitting position. The patient closes his nose with a clamp and holds a disposable mouthpiece with his mouth, which is combined with the spirometer tube.

This is necessary so that the respiratory process passes only through the mouth, and the entire air flow is taken into account by the spirometer. After installing all the necessary devices, the diagnostic itself begins. As a rule, testing takes place several times and then the average value is taken to minimize the error.

The duration of the FVD study is always different, since it depends on the methodology, but on average it takes no more than 30 minutes. If a test with bronchodilators is needed, then the diagnosis period may increase and require a second examination. Preliminary data (without doctor's comment) will be ready almost immediately.

Study preparation

Before the study of the respiratory function, special preparation is not required, however, it is still worth excluding any physical and nervous stress, physiotherapy; stop eating 2 hours and smoking 4 hours before the diagnosis; empty the intestines and bladder; refrain from taking bronchodilators (ventolin, berodual, atrovent, etc.) and caffeine-containing drugs (including and) 8 hours before the examination; exclude inhalation (except mandatory!); wash off lipstick; loosen the tie, unbutton the collar.

Be sure to take a doctor's referral for diagnosis with you, and if such an examination has already been carried out before, then the results of the previous study.

The patient must know the exact weight and height. Before starting the procedure, you need to be in a sitting position for 15 minutes, so the patient should arrive a little in advance. You need to wear loose clothing that does not restrict the activity of the chest during increased breathing. It is also strictly forbidden to take aminophylline or other similar drugs on the eve of the examination, after taking these drugs, at least a day must pass.